The impact of contextual socioeconomic and demographic characteristics of residents on COVID-19 outcomes during public health restrictions in Sydney, Australia

Maria Gabriela Uribe Guajardo; Corey Moore; Vicki Giannopoulos; Hueiming Liu; Amber Tickle; Pejman Adily; Ferdinand C. Mukumbang; Emma Quinn; Michelle Cunich; Ilan Katz; Andrew Page; Susan Wolfenden; James Gillespie; Paul Haber; Andrew Wilson; Leena Gupta; John Eastwood; Carmen Huckel Schneider

doi:10.1016/j.anzjph.2025.100228

Australian and New Zealand Journal of Public Health (Apr 2025)

The impact of contextual socioeconomic and demographic characteristics of residents on COVID-19 outcomes during public health restrictions in Sydney, Australia

Maria Gabriela Uribe Guajardo,
Corey Moore,
Vicki Giannopoulos,
Hueiming Liu,
Amber Tickle,
Pejman Adily,
Ferdinand C. Mukumbang,
Emma Quinn,
Michelle Cunich,
Ilan Katz,
Andrew Page,
Susan Wolfenden,
James Gillespie,
Paul Haber,
Andrew Wilson,
Leena Gupta,
John Eastwood,
Carmen Huckel Schneider

Affiliations

Maria Gabriela Uribe Guajardo: Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia; Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Correspondence to: Maria Gabriela Uribe Guajardo, Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia
Corey Moore: Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia; Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Public Health Unit, Nepean Blue Mountains Local Health District, Sydney, Australia; Public Health Unit, Sydney Local Health District, New South Wales, Sydney, Australia; Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, NSW, 2050, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
Vicki Giannopoulos: Edith Collins Centre, Drug Health Services, Sydney Local Health District, Camperdown, Australia
Hueiming Liu: Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; George Institute, University of New South Wales, Sydney, Australia
Amber Tickle: Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Public Health Unit, Sydney Local Health District, New South Wales, Sydney, Australia; Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, NSW, 2050, Australia
Pejman Adily: Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
Ferdinand C. Mukumbang: Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, NSW, 2050, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; School of Global Health, University of Washington, Seattle, Washington, United States
Emma Quinn: Health Protection New South Wales, Ministry of Health, Sydney Australia; School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
Michelle Cunich: Boden Initiative, Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Sydney Health Economics Collaborative, Sydney Local Health District (SLHD), Sydney, New South Wales, Sydney, Australia
Ilan Katz: Social Policy Research Centre, University of New South Wales, Australia
Andrew Page: Translation Health Research Institute, Western Sydney University, Sydney, Australia
Susan Wolfenden: Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Population Child Health Research Group, University of New South Wales, Sydney, Australia
James Gillespie: Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia
Paul Haber: Edith Collins Centre, Drug Health Services, Sydney Local Health District, Camperdown, Australia
Andrew Wilson: Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia
Leena Gupta: Public Health Unit, Sydney Local Health District, New South Wales, Sydney, Australia
John Eastwood: Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia; Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, NSW, 2050, Australia; Sydney Local Health District, Sydney, Australia
Carmen Huckel Schneider: Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Sydney, Australia

DOI: https://doi.org/10.1016/j.anzjph.2025.100228
Journal volume & issue: Vol. 49, no. 2
p. 100228

Abstract

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Objective: To investigate the impact of contextual socioeconomic and demographic characteristics of residents on COVID-19 outcomes during public health measures. Methods: Aggregated data from the NSW Notifiable Conditions Information Management System linked to Australian Census data, by periods of strict and relaxed measures, were used. Results: During strict measures, residents of areas of lower socioeconomic status (SES) had a higher risk of infection, with the lowest areas having greater risk compared with the highest areas ((hazard ratio (HR)) 7.15, 95% confidence interval (CI) 6.24-8.19). The risk of infection was lower for those aged 40 and over and was higher for males (HR 1.34, 95% CI 1.27-1.40); those in living in areas with larger household sizes (HR 1.56, 95% CI 36-1.78); and individuals in areas with a large proportion of residents born in South Asia (HR 1.18; 95% CI 1.07-1.29), South East Asia (HR 1.20, 95% CI 1.07-1.36) and the Middle East and North Africa (HR 1.67, 95% CI 1.47-1.90). During relaxed restrictions, the impact of variables attenuated but remained significant. Conclusions: Minorities, those residing in lower SES areas and those living in larger households had worse COVID-19 outcomes during strict public health measures. Implications for Public Health: Decision-makers should tailor services to avoid inequities.

Published in Australian and New Zealand Journal of Public Health

ISSN: 1326-0200 (Print); 1753-6405 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.sciencedirect.com/journal/australian-and-new-zealand-journal-of-public-health

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